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. � <br /> Total Fee: $ Date Received: <br /> Entered By: Permit#: <br /> CITY OF OI20N0 - BUILDING PERMIT APPLICATION <br /> All information must be submitted in full before plan review will be stai�ted. <br /> (please print all i�rformation) <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> THE APPLICANT iS: (circle one) WNE OR CONTRACTOR <br /> JOB SITE ADDRESS: �c� ��� �- �` �' e '`i� ZZp: S S s`�l ( <br /> Will this be a Pa�•ade of Homes, Remodelers Showcase Home or other Display Home? <br /> ❑ Yes �NO If yes, a special event per-rnit is reqa�ired with Police Depnr-tme��t and City Council approval <br /> 60 days prior to the event. Slzzrttle bus seivice will be reqt�ired a�nless applicant demonstrates <br /> strfficient on-site parking is available. Non permrtted events will not be allowed. <br /> NAME OF OWNER �1`'l. �i4��=��R� PHONE: (home)�7SZ ����Q�� <br /> (work) <br /> MAI�ING ADDRESS: ���'�� �'7 ���- ►�� CITY: ���'� ZIP: SS 39/ <br /> CONTRACTOR: ���- � PHONE: <br /> CONTACT PERSON: MOBILE/PAGER: <br /> MAILING ADDRESS: CITY: ZIP: <br /> STATE LICENSE: # EXPIRATION DATE: <br /> ARCHITECT/ENGINEER: ti �,A PHONE: <br /> MAILING ADDRESS: CITY: ZIP: <br /> NAME: REGISTRATION: # <br /> TYPE OF WORK: New Addition Accessory Structure <br /> Move Home RemodeUAlteration � <br /> PROPOSEDWORK(desct�ibein detai�: �-���J� ���l�c�- ��c�� sr-►�^�� �S <br /> STORIES: Z. SQ.FEET OF EACH FLOOR: y �� <br /> NO. OF BEDROOMS: Z. GARAGE STALLS: ATTACHED DETACHED r/ <br /> ESTIMATED CONSTRUCTION VALUATION(excluding land): $ (a�� ,��" <br /> I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; <br /> that the work will be in conformance with the ordinances and codes of the City and with the State Building <br /> Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be <br /> in accordance with the approved plan. <br /> APPLICANT'S SIGNATURE: --� �' DATE: � �S, �..5� <br /> �-- <br /> 31 <br />